N-Acetyl-L-cysteine is a compound widely used for treating chronic obstructive airway diseases/chronic bronchitis (for further references see Multicentre Study Group. Long-term oral acetylcysteine in chronic bronchitis. A double-blind controlled study. Eur. J. Respir. Dis. 1980, 61 (suppl. 111), 93-108; Boman, G., Backer, U., Larsson, S., Melander, B., and Wahlander, L. Oral acetylcysteine reduces exacerbation rate in chronic bronchitis. Report of a trial organized by the Swedish Society for Pulmonary Disease. Eur. J. Respir. Dis. 1983, 64, 405-415; and British Thoracic Society Research Committee. Oral N-acetylcysteine and exacerbation rates in patients with chronic bronchitis and severe airway obstruction. Thorax 1985, 40, 832-835). The mechanism of action of the compound is not disclosed; its effect has been attributed to mucolytic properties (see Multicentre Study Group. Long-term oral acetylcysteine in chronic bronchitis. A double-blind controlled study. Eur. J. Respir. Dis. 1980, 61 (suppl. 111), 93-108; Boman, G., Backer, U., Larsson, S., Melander, B., and Wahlander, L. Oral acetylcysteine reduces exacerbation rate in chronic bronchitis. Report of a trial organized by the Swedish Society for Pulmonary Disease. Eur. J. Respir. Dis. 1983, 64, 405-415; and British Thoracic Society Research Committee. Oral N-acetylcysteine and exacerbation rates in patients with chronic bronchitis and severe airway obstruction. Thorax 1985, 40, 832-835), antioxidant properties (see Aruoma, O. I., Halliwell, B., Hoey, B. M., and Butler, J. Free Radical Biol. Med. 1989, 6, 593-597), and also immunomodulating properties (see Bergstrand, H., Bjornson, A., Eklund, A., Hernbrand, R., Eklund, A., Larsson, K., Linden M., and Nilsson, A. Stimuli-induced superoxide radical generation in vitro by human alveolar macrophages from smokers: Modulation by N-Acetylcysteine treatment in vivo. J. Free Radicals Biol. & Med. 2, 1986, 119-127).
Also known is N,N'-diacetyl-L-cystine. This compound has previously shortly been described in the patent literature as well as in the scientific literature (U.S. Pat. No. 4,827,016; EP 300100; U.S. Pat. No. 4,724,239; U.S. Pat. No. 4,708,965; DE 2326444; Wilson, I. D., and Nicholson, J. K. Analysis of thiols and disulfides in Sulphur-containing drugs and related organic compounds. Chemistry, Biochemistry and Toxicology (ed L. A. Damani) Vol. 2A. Analytical, biochemical and toxicological aspects of sulphur xenobiochemistry. Ellis Horwood Series in Biochemical Pharmacology (Halstred Press: a division of John Wiley & Sons) Chichester 1989, p. 45; and Sjodin, K., Nilsson, E., Hallberg, A., and Tunek, A. Metabolism of N-Acetyl-L-cysteine. Some structural requirements for the deacetylation and consequences for the oral bioavailability. Biochem. Pharmacol. 1989, 38, 3981-3985). In U.S. Pat. No. 4,827,016 the compound is claimed to be effective for topical treatment of dermal inflammations which are induced and propagated by leukotrienes. However, nothing has been reported or generally known regarding its pharmacological and/or therapeutic properties with respect to immunological systems and inflammatory diseases of the lung such as chronic bronchitis.
Previously, immunostimulating properties have been reported for simple disulfides such as hydroxyethyldisulfide (HEDS, see: St. Georgiev, V. New synthetic immunomodulating agents. Trends in Pharmacological Science 1988, 446-51).